Quality Specialist

Quality SpecialistThe Quality Specialist reviews and evaluates customer service calls to ensure they meet established quality, compliance, and performance standards within U.S. healthcare operations. This role focuses on assessing both task completion and the quality of communication, identifying trends, and providing actionable feedback to improve agent performance and customer experience. The Quality Specialist also supports continuous improvement by testing process changes, flagging technical or workflow issues, and serving as a subject matter expert across multiple client programs in a fully remote environment.ResponsibilitiesReview calls flagged by automated systems or selected through random sampling and determine whether agents handled them correctly according to defined quality standards.Assess call quality using structured rubrics and accurately label outcomes so that performance patterns are easy to track and analyze over time.Evaluate agent tone, empathy, and communication style in addition to task completion, and provide specific, constructive feedback on how conversations can be improved.Monitor live call queues using dashboards to keep call flow moving on schedule and ensure volume and timing remain on track.Run daily quality checks against established audit standards and help identify recurring issues before they develop into broader performance patterns.Test agent behavior and workflows before and after updates go live, confirming that changes work as intended before they impact real customer calls.Flag technical or workflow issues to Product and Engineering teams and assist in troubleshooting until the issues are resolved.Contribute ideas for improving call scripts, workflows, and internal processes based on insights gained from call reviews and quality audits.Work across more than one client program as needed, adapting to the specific requirements and nuances of each program.Take ownership of one or more customer accounts as a subject matter expert, including participating in meetings, leading or supporting quality audits, and helping to train and mentor newer team members.Essential SkillsExperience in U.S. healthcare operations such as insurance verification, medical billing, benefits administration, or healthcare call center operations.Background in quality assurance, quality control, audit, or document control within a process-driven environment.Ability to work through a high volume of tasks quickly while maintaining a high level of accuracy, especially during busy periods.Strong attention to detail with a habit of noticing when information or processes do not look correct.Clear written and verbal communication skills for documenting findings and delivering feedback to stakeholders.Sound judgment and problem-solving skills, with the ability to make decisions and explain the reasoning behind them.Ability to work independently once trained while staying closely coordinated and communicative with the wider team.Willingness and ability to work in compliance with HIPAA and handle sensitive healthcare information responsibly.Additional Skills & QualificationsPrior experience in a healthcare-focused quality assurance or audit role.Familiarity with structured quality rubrics and performance tracking tools.Experience providing feedback and coaching to customer service agents or operations staff.Comfort working across multiple programs or accounts with differing processes and requirements.Experience contributing to process improvements, including call scripts, workflows, or internal procedures.Work EnvironmentThis is a fully remote role that allows you to perform all responsibilities from a home-based or off-site location. You will work extensively with digital tools, dashboards, and call review systems to monitor queues, evaluate calls, and document findings. Collaboration with cross-functional teams such as Product and Engineering occurs virtually through online communication and meeting platforms. The work involves handling sensitive healthcare information in a secure environment, following HIPAA-compliant practices and data protection protocols.Job Type & LocationThis is a Contract to Hire position based out of San Francisco, CA.Pay and BenefitsThe pay range for this position is $21.00 - $23.00/hr.Individual compensation offered for this position within this range will depend on many factors, including qualifications, skills, relevant experience, job knowledge, geographic location, internal equity, and other pertinent job-related factors.Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: Medical, dental & vision Critical Illness, Accident, and Hospital 401(k) Retirement Plan Pre-tax and Roth post-tax contributions available Life Insurance (Voluntary Life & AD&D for the employee and dependents) Short and long-term disability Health Spending Account (HSA) Transportation benefits Employee Assistance Program Time Off/Leave (PTO, Vacation or Sick Leave)